摘要
目的:探讨来曲唑联合枸橼酸氯米芬治疗多囊卵巢综合征(PCOS)不孕症患者的临床疗效。方法:选取2023年3月~2024年6月期间某院妇科门诊收治的150例PCOS不孕症患者作为研究对象,采用随机数字表法分为枸橼酸氯米芬组、来曲唑组和联合组,每组50例。枸橼酸氯米芬组患者采用枸橼酸氯米芬胶囊治疗,来曲唑组患者采用来曲唑片治疗,联合组患者采用枸橼酸氯米芬胶囊联合来曲唑片治疗。比较三组患者子宫内膜及卵泡发育情况、排卵率、性激素指标[黄体生成素(LH)、雌二醇(E_(2))、促卵泡激素(FSH)、睾酮(T)、LH/FSH]、妊娠结局(临床妊娠率、多胎妊娠率、早期流产率)及并发症发生情况。结果:治疗后,来曲唑组和联合组患者的子宫内膜厚度、成熟卵泡个数、宫腔容积均优于枸橼酸氯米芬组(P<0.05),且联合组改善效果更优(P<0.05)。人绒毛促性腺激素(HCG)注射日,来曲唑组和联合组患者LH、FSH、T和LH/FSH均低于枸橼酸氯米芬组(P<0.05),E_(2)水平均高于枸橼酸氯米芬组(P<0.05),且联合组各项指标变化幅度更显著(P<0.05)。来曲唑组和联合组患者排卵率、临床妊娠率均高于枸橼酸氯米芬组(P<0.05),且联合组更高(P<0.05)。三组患者多胎妊娠率和早期流产率比较均无统计学差异(P>0.05)。来曲唑组和联合组患者并发症总发生率均低于枸橼酸氯米芬组(P<0.05)。结论:来曲唑联合枸橼酸氯米芬可提高PCOS不孕症患者的排卵率和成功妊娠率,调节性激素水平,具有一定的临床价值。
Objective:To investigate the clinical efficacy of letrozole combined with clomifene citrate in treating infertility patients with polycystic ovary syndrome(PCOS).Methods:A total of 150 infertility patients with PCOS admitted to the gynecology clinic of a hospital from March 2023 to June 2024 were selected and assigned to one of three groups(50 patients each):the clomifene citrate group,the letrozole group and the combination therapy group.The clomifene citrate group was treated with clomifene citrate capsules.The letrozole group was treated with letrozole tablets.The combination therapy group was treated with both clomifene citrate capsules and letrozole tablets.The endometrial and follicular development,ovulation rates,sex hormone[luteinizing hormone(LH),estradiol(E_(2)),follicle-stimulating hormone(FSH),testosterone(T),LH/FSH],pregnancy outcomes(clinical pregnancy rate,multiple pregnancy rate,early miscarriage rate)and incidence of complications were compared among the three groups.Results:After treatment,endometrial thickness,number of mature follicles and uterine cavity volume in the letrozole group and the combination therapy group were superior to those in the clomifene citrate group(P<0.05),with the combination therapy group showing more significant improvement(P<0.05).On the day of human chorionic gonadotropin(HCG)administration via injection,LH,FSH,T and LH/FSH ratio in the letrozole group and the combination therapy group were lower than those in the clomifene citrate group(P<0.05),while E_(2) levels were higher than those in the clomifene citrate group(P<0.05).Moreover,the changes in all these hormonal parameters were more pronounced in the combination therapy group(P<0.05).The ovulation rates and clinical pregnancy rates in the letrozole group and the combination therapy group were higher than those in the clomifene citrate group(P<0.05),with the combination therapy group showing higher value(P<0.05).No statistically significant differences in multiple pregnancy rates and early miscarriage rates were observed among the three groups(P>0.05).The total incidence of complications in the letrozole group and the combination therapy group was lower than that in the clomifene citrate group(P<0.05).Conclusion:Letrozole combined with clomifene citrate can improve ovulation rates and successful pregnancy rates,and regulate sex hormone levels in infertility patients with PCOS,demonstrating certain clinical value.
作者
陈丽思
尹慧霞
陈盈
CHEN Li-si;YIN Hui-xia;CHEN Ying(Hospital of Changan Dongguan,Dongguan 523843,China)
出处
《中国合理用药探索》
2025年第12期95-100,共6页
Chinese Journal of Rational Drug Use
基金
东莞市社会发展科技(面上)项目(20231800926352)。
关键词
多囊卵巢综合征
不孕症
来曲唑
枸橼酸氯米芬
临床疗效
polycystic ovary syndrome
infertility
letrozole
clomifene citrate
clinical efficacy
